URJ 4/2017

2017, vol XXV, #4, page 257

I. YU. CHERNIAVSKYI1, V. A. VINNIKOV2

1 National Technical University «Kharkiv Polytechnic Institute»

2 SI «Grigoriev Institute for Medical Radiology of National Academy of Medical Sciences of Ukraine», Kharkiv

ANALYSIS OF FACTORS DEFINING INCAPACITATION OF PEOPLE UNDER CONDITIONS OF UNEVEN IRRADIATION DURING NUCLESR EXPOLISION GAMMA-NEUTRON EMISSIION

Purpose. To estimate the possibility of consideration of factors leading to uneven irradiation in order to correct the prognosis of radiation injury severity and to assess incapacitation of the personnel during nuclear explosion gamma-neutron emission.

Materials and methods. Information search in accordance with literature data, information analysis and synthesis methods, mathematical modelling.

Outcomes. According to the mathematical modelling findings representing radiation-induced incapacitation observed in the personnel, ranging of factors, necessary for inclusion into the model of radiation injury severity prognosis during the action of modern nuclear ammunition, was carried out for different irradiation conditions. It is considered to be dramatically important to take into account the ratio of γ/n component and spectral features of neutron emission as basic factors for estimation of radiation injury severity under conditions of impulse action of gamma neutron emission resulting from nuclear explosion. The principal mechanism of urgent incapacitation of the personnel under conditions of nuclear ammunition explosion is cranial irradiation in high doses which leads to oropharyngeal and early transitional incapacitation syndromes.

Conclusions. Under conditions of employing neutron ammunition, a basic assessment has to be made in case of severe form of acute radiation disease and death of people who were exposed within several days. In this case the number of people who have medium and mild severity is comparatively small, so the incapacitation of these people is postponed from the moment of penetrating radiation impact for a few hours.

The approach which has been outlined above is considered to be rather applicable for inclusion into a new concept of military radiation security in terms of assessment of affecting action of modern nuclear ammunition.

Keywords: gamma-neutron emission of penetrating radiation, uneven irradiation, capacity.

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2017, vol XXV, #4, page 268

I. YA. VASYLIEV, H. V. KULINICH, YE. B. RADZISHEVSKA, A. S. SAVCHENKO

SI «Grigoriev Institute for Medical Radiology of National Academy of Medical Sciences of Ukraine», Kharkiv

FINDINGS OF THE ANALYSIS OF ANTINEOPLASTIC THERAPY IN PATIENTS WITH THYROID CANCER AT EARLY STAGES OF SPECIAL TREATMENT

Purpose. To estimate the risks of negative outcomes of treatment provided for patients with thyroid cancer.

Materials and methods. The object of research is to estimate risks of development of early somatic neurological complications depending on the scheme of treatment of the thyroid according to the findings obtained due to analysis of 120 case histories of the patients. Research methods: nonparametric statistics methods, multivariance statistical analysis, hidden knowledge search technology.

Outcomes. According to the accumulated data packages the frequency of unfavorable early somatic neurological consequences was ascertained, i.e. anemia — 15.8%, sialoadenitis — 27.5%, gastritis — 2.5%, heart beat disorder — 72.5%, polyneuropathy — 83,0%. The dependence of appearing on present concomitant pathology (hypoparathyrosis, hypocalcemia, peptic ulcer, diabetes mellitus, hypertension, cardiac failure, connective tissue diseases, varix dilatation of the lower extremities) and medical history data such as age, sex, disease stage, number of surgeries and radionuclide treatment courses, EСOG scale condition was clarified for the first time.

Conclusions. The factors which affect appearing of immediate complications of radioactive iodine therapy at a statistically significant level were ascertained.

It was specified that these factors include concomitant somatic diseases, involving cardiovascular, endocrine and nervous systems in particular.

The further analysis of accumulated experience of treatment of thyroid cancer will make it possible to elaborate approaches to optimization choice of appropriate treatment schemes and post-treatment monitoring of patients.

Keywords: thyroid cancer, thyreotoxicosis, radioiodine therapy, somatic and neurological complications.

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2017, vol XXV, #4, page 276

L. O. HAYSENIUK, H. V. KULINICH, L. L. STADNYK

SI «Grigoriev Institute for Medical Radiology of National Academy of Medical Sciences of Ukraine», Kharkiv

EXPERTISE OF OCCUPATIONAL THYROID CANCER IN PATIENTS DEALING WITH IONIZING EMISSION SOURCES

Purpose. To analyze cases of occupational thyroid cancer in workers exposed to ionizing emission action.

Outcomes. The research is based on the analysis of 14 case histories of patients with thyroid tumors. Twelve patients out of 14 were diagnosed with thyroid cancer, 2 — with mixed and multinodular goite. All patients underwent surgery: 6 — hemistrumectomy, 8 — subtotal thyroid resection with lymphodissection. The histological examination showed papillary carcinoma in 11 patients, follicular carcinoma in 1 patient. Among the patients with thyroid cancer, 5 had stage I, 6 — stage II, 1 — stage III. According to the Guidelines and Procedures Letter of the Central Medical Advisory Committee of SI Grigoriev Institute for Medical Radiology of NAMS of Ukraine No 20/1377 dated 22/12/2010, the Central Dispensary Committee diagnosed occupational cancer in 5 patients with thyroid cancer exposed to ionizing emission from 2011 to 2017. For the cases observed in patients of this category, whose case histories were considered before 2011, the diagnosis of occupational cancer was not established due to absence of this diagnosis in the Occupational Diseases List according to Resolution of the Cabinet of Ministers of Ukraine No 1662 dated 08/11/2000.

Conclusions. A small number of case histories of patients with thyroid neoplasms who deals with ionizing emission sources has to be estimated. The current issue is further improvement of diagnostic criteria of occupational cancer in workers of this category.

Keywords: workers exposed to ionizing emission, occupational cancer criteria, occupational cancer.

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2017, vol XXV, #4, page 280

L. O. HAYSENIUK, H. V. KULINICH, L. L. STADNYK, M. V. MOSKALENKO

SI «Grigoriev Institute for Medical Radiology of National Academy of Medical Sciences of Ukraine», Kharkiv

CENTRAL DISPENSARY COMMITTEE EXPERIENCE IN PROVIDING EXPERTISE  OF OCCUPATIONAL CANCERS IN WORKERS DEALING WITH IONIZING EMISSION

Purpose. To analyze CDC experience in providing expertise of occupational cancers in workers dealing with ionizing emission.

Outcomes. The analysis involved 305 case histories of patients exposed to ionizing emission, where 90 % — uranium mining and processing industry workers; an assessment of case histories in competition with regulatory documents which contained the list of occupational diseases of this category workers was made. A reconstructive estimation was provided along with the analysis of accumulated doses of occupational irradiation of workers which typically did not exceed critically affordable doses according to Radiation Safety Standarts of Ukraine-97. In 159 patients out of 305 with oncological pathology employed under harmful conditions for no more than 10 years, the diagnosis of occupational cancer was established. Among occupational cancers the most frequent cancer types are lung and respiratory system cancer — 105 cases (66 %); the next group was represented by blood formation disorders — 19 cases (11.9 %); in some cases different cancer locations like thyroid, oral cavity salivary glands, skin, urinary bladder, kidney, esophagus cancer that were recognized as occupational according to the Occupational Diseases List in accordance with Resolution of the Cabinet of Ministers of Ukraine No 1662 dated 08/11/2000 and the Guidelines and Procedures Letter of the Central Medical Advisory Committee of SI Grigoriev Institute for Medical Radiology of AMS of Ukraine No 20/1377 dated 22/12/2010.

Conclusions. CDC experience substantiates the significance of further elaboration of diagnostic criteria for diagnosing occupational diseases in workers dealing with ionizing emission.

Keywords: uranium mining and processing industry workers, case histories, occupational irradiation doses, occupational cancer criteria, occupational cancer.

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2017, vol XXV, #4, page 286

V. S. SUKHIN

SI «Grigoriev Institute for Medical Radiology of National Academy of Medical Sciences of Ukraine», Kharkiv

RADIATION THERAPY IN STAGE I–II UTERINE SARCOMA

Sarcoma is one of the most aggressive and rare tumors, and its incidence makes up 3 to 9 % of all tumors of the uterus. Operative intervention is a standard treatment for such patients, and in recent years it has not undergone any significant changes that could significantly improve long-term results, and in particular reduce the incidence of local recurrence. Today there is no convincing evidence on the positive effect of any adjuvant therapy, including radiation treatment. At the same time, radiotherapy reduces the incidence of locoregional relapses, but still does not affect the incidence of distant metastases. This review studies the use of radiotherapy with different histotypes of sarcoma, the interdependence between postoperative radiotherapy in patients with sarcoma, and improved locoregional control, which in turn correlates with the presented data of our own research.

Keywords: uterine sarcoma, radiotherapy, specificity of survival.

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2017, vol XXV, #4, page 290

K. V. NEMALTSOVA

SI «Grigoriev Institute for Medical Radiology of National Academy of Medical Sciences of Ukraine», Kharkiv

CAPABILITIES OF MARKER DIAGNOSIS OF OVARIAN MALIGNANCY

The problem of malignant ovarian tumors (MOT) is very acute around the world, as more than 200 000 cases of this pathology are diagnosed annually. The main reasons for the low survival rate of MOT patients are asymptomatic course early in the disease and low informativeness of diagnostic techniques at its early stages. The review deals with the use of serological tumor-associated markers in the diagnosis, monitoring of treatment and preclinical detection of the development of MOT relapses. The expediency of using the CA19-9, CA72-4, CYFRA 21-1 and HE-4 markers in conjunction with the generally recognized CA-125 marker for the diagnosis of epithelial ovarian tumors is discussed. The principal values of α-FP and β-HCG in germinogenic ovarian tumors are shown, as well as the use of inhibin B and anti-Mueller hormone in the diagnosis of granulosa cell tumors of the ovaries.

Keywords: malignant ovarian tumors; ovarian cancer; tumor-associated markers; oncomarkers; marker diagnosis.

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2017, vol XXV, #4, page 297

T. S. SYPKO, N. A. MAZNYK

SI «Grigoriev Institute for Medical Radiology of National Academy of Medical Sciences of Ukraine», Kharkiv

CYTOGENETIC DAMAGES IN ONCOLOGICAL PATIENTS DUE TO EXTERNAL RADIATION THERAPY FROM DIFFERENT RADIATION SOURCES

Summary. The review of literature is presented with a description of the existing cytogenetic methods used in studies of the radiation therapy effects from different radiation sources in normal tissues. It was shown that publications devoted to cytogenetic effects of radiation therapy could be divided into three groups according to the research purposes and prospective areas of research: 1) solving biodosimetry tasks in the interpretation of cytogenetic data at partial and fractionated irradiation exposure in humans; 2) investigation of the radiation damages in lymphocytes depending on the localization of tumors, sources, type and schemes of radiation treatment; 3) search for cytogenetic predicative markers of individual radiosensitivity and early and late radiation injuries occurrence. There is large group of publications on the indirect radiation effects study with the aims similar to those of the second and third groups. Some of the methodological aspects of cytogenetic studies in area of different radiation energies are discussed.

Keywords: chromosome aberrations, radiation therapy, biodosimetry, nontargeted effects, quality and energy of radiation, review.

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2017, vol XXV, #4, page 309

M. V. KRASNOSELSKIY1, 2, A. N. BELIY1, 2, E. N. KRUTKO1

1 SI «Grigoriev Institute for Medical Radiology of National Academy of Medical Science of Ukraine», Kharkі2 Kharkiv National Medical University

PECULIARITIES OF DIAGNOSTICS AND TREATMENT  OF PRIMARY-MULTIPLE TUMOR PROCESS

The article describes the case of a primary-multiple malignant process in a patient of 27 years. The patient at the diagnostic stage revealed a sarcoma of the posterior-lower mediastinum and cancer of the left breast. Only a laparotomy about suspicion of intra-abdominal bleeding in a month after surgical treatment of sarcoma of the posterior-lower mediastinum and cancer of the left breast allowed to reveal the tumor of the retroperitoneal space with the spread in the abdominal cavity, which was not visualized on the computer tomography.

Keywords: primary-multiple malignant process, myofibroblastic sarcoma, breast cancer, surgical treatment.

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2017, vol XXV, #4, page 314

DENYS V. VARYVONCHYK

SI «Institute for Occupational Health of NAMS of Ukraine»

Shupyk National Medical Academy of Postgraduate Education, Kyev

CRITERINAL CLINICAL-EPIDEMIOLOGICAL  APPROACHES TO THE EXPERT INSTALLATION OF OCCUPATIONAL ETIOLOGY OF CANCER

To determine the occupational causes of cancer need to use recommended by the WHO and ILO clinical and epidemiological criteria and certain absolute criteria in Ukraine (2006).

There are a number of complex scientific questions in the examination of occupational cancer when exposed to X-ray and gamma-ray radiation, the decision of where further research should be directed.

Keywords: occupational cancer, the examination criteria.

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